Loading...
HomeMy WebLinkAbout03-28-14 pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION f APP,.DRAISEMENT, ALLOWANCE OR DISALLOWANCE -. PO BOX 280601 PA 17128-0681 RECMYoWIN PI IR TRUSTS ASSETS AX ON REY 1548IX Afl' (12-13)OF HARRISBURG REGISTER OF WILLS DATE 03-31-2014 11pp �O ryry IIn� 'Iy ��yyESTATE OF WRIGHTS GLORIA G Q1i }RR 28 AM �lLFILE NUMBER TH 21-13-0361 CLERK OF COUNTY CUMBERLAND SSN/DC RONALD R ELLIOTT ORPHANS' COURT ACN 13122857 1548 ORRSTOWN RD �ffiERLANO CO., PA APPEAL BY DATE:05-30-2014 SHIPPENSBURG PA 17 8821 (See reverse side under Objections) Amount Remitted F— MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS +— -__-_---_-_----_-----__--__----_---__ __---_-__-_-_-_-_ REV-1548 EX AFP C12-I3) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-31-2014 ESTATE OF:WRIGHTS GLORIA G DATE OF DEATH:03-19-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0361 S.S/D.C. NO. : ACN: 13122857 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PATRIOT FCU ACCOUNT NO. : 4951096240-00 TYPE OF ACCOUNT: ( X)SAVINGS C ) CHECKING ( )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 02-22-1993 Account Balance 46,236.86 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 23 118.43 UPPER PORTION OF THIS NOTICE Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 23,118.43 REGISTER OF WILLS AT THE Tax Rate v • 15 ABOVE ADDRESS. MAKE CHECK Tax Due 3,467.76 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 04-08-2014 TOTAL TAX PAYMENT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 3,467.76 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 31.28 TOTAL DUE 3,499.04 + IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. t „� IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION APPRAZSEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (12-15) HARRISBURG PA 27728.8602 JOINTLY HELD OR TRUST ASSETS RECORDED OFFIC� 03-31-2014 REGISTER OF WILPI ETOFODEATH 03-19-2013 GLORIA G n �mDppp O pp�mD FILE ! NUMBER 21 13-0361 20=4 t 117!1 28 tt:t 1; DC RONALD R ELLIOTT ACN' 13122858 1548 ORRSTOWN RD CLERK OF APPEAL BY DATE:05-30-2014 SHIPPENSBURG PA 17257-4aPHANS' COURT (See reverse side under Objections) CUMBERLAND CO., Amount Remitted F-------� E CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS -'----`-`-'-'----`-_-'-------------------------------------------`------------------------- REY-1548 EX AFP C12-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-31-2014 ESTATE OF:WRIGHTS GLORIA G DATE OF DEATH:03-19-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0361 S.S/D.C. NO. : ACN: 13122858 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PATRIOT FCU ACCOUNT NO. : 4951096240-25 TYPE OF ACCOUNT: ( )SAVINGS ( X) CHECKING ( )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 02-22-1993 Account Balance 1 ,590.27 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 795.14 UPPER PORTION OF THIS NOTICE Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 795.14 REGISTER OF WILLS AT THE Tax Rate Y . 15 ABOVE ADDRESS. MAKE CHECK Tax Due 119.27 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 04-08-2014 - TOTAL TAX PAYMENT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 119.27 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 1.08 TOTAL DUE 120.35 z IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. �ll1l pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (12-13) HARRISBURG PA 1 71 28-06 01 , , JOINTLY HELD OR TRUST ASSETS DATE 03-31-2014 RECORDED OFFICE ESTATE OF WRIGHTS GLORIA G REGISTER OF WILL ILE NUMBERTH 21 13-0361 Qp pO� y COUNTY CUMBERLAND RONALD R ELLIOTT 2014 MIit} 28 flip 11 J?N/DC 1548 ORRSTOWN RD t APPEAL BY DATE:05-30-2014 SHIPPENSBURG PA 17257-8,2gLEIIK OF (See reverse side under Objections) ORPHANS' COURT Amount Remitted CUMBERLAND CO., PMAKE CHECK PAYABLE AND, REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ^41 RETAIN LOWER PORTION FOR YOUR RECORDS F REV-1548 EX AFP (12-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-31-2014 ESTATE OF:WRIGHTS GLORIA G DATE OF DEATH:03-19-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0361 S.S/D.C. NO. : ACN: 13122859 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PATRIOT FCU ACCOUNT NO. : 1096290-25 TYPE OF ACCOUNT: ( )SAVINGS ( X) CHECKING ( )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 05-22-1989 Account Balance 6,271 .43 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 3,135.72 UPPER PORTION OF THIS NOTICE Debts and Deductions - -00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 3,135.72 REGISTER OF WILLS AT THE Tax Rate y •15 ABOVE ADDRESS. MAKE CHECK Tax Due 470.36 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) INTEREST IS CHARGED THROUGH 04-08-2014 TOTAL TAX PAYMENT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 470.36 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 4.24 TOTAL DUE 474.60 + IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST- IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND- k\{� SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. �l! pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE-TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE'OR DISALLOWANCE d,,,fiyyRU;#,N „psgCee y7 REV-1548 EX AFP (12-13) PO BOX 280601 OF HR�ti``1177 ttr! CA. DiDi]]''OFRFTTr'RTWGSM ,AY OF TAX ON HARRISBURG PA 171?8-U601 ,1q NTLY L F SSETS RHISTER OF WA LS 03-31-2014 q II11ItDIIQQpp pp nI0EmSTATE OF WRIGHTS GLORIA G L�17 i1aJt! 20 IttY' �}E`'��ff DEATH 03-19-2013 Ft�`Nt1MBER 21 13-0361 CLERK Q COUNTY CUMBERLAND CCSSN/DC RONALD R ELLIOTT ORPHANS' Cot4m 13122860 1548 ORRSTOWN RD CUMBERLAND Co., pfPPEAL BY DATE:05-30-2014 SHIPPENSBURG PA 17257-8821 'Mee reverse side under Objections) Amount Remitted t--- --� MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS ____________________________________________________________________ REV-1548 EX AFP C12-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-31-2014 ESTATE OF:WRIGHTS GLORIA G DATE OF DEATH:03-19-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0361 S.S/D.C. NO. : ACN: 13122860 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PATRIOT FCU ACCOUNT NO. : 1096290-00 TYPE OF ACCOUNT: CXISAVINGS C ) CHECKING ( )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 06-21-1979 Account Balance 9,201.72 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 4,600.86 UPPER PORTION OF THIS NOTICE Debts and Deductions •00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 4,600.86 REGISTER OF WILLS AT THE Tax Rate v . 15 ABOVE ADDRESS. MAKE CHECK Tax Due 690. 13 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) INTEREST IS CHARGED THROUGH 04-08-2014 TOTAL TAX PAYMENT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 690. 13 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 6.22 TOTAL DUE 696.35 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. `n� IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS, �. pennsytvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 /�/� OF DEDUCTIONS, 1i EAI,N.pD ASSESSMENT OF TAX ON REV-1548 EX AFP (12-131 HARRISBURG PA 17128-0601 RECORDEOJOi-I'11+C 4JFOR TRUST ASSETS 11n REGISTER Vn(E'I'�r{ti'+LLtSJ DATE 03-31-2014 R E IJ R J ESTATE OF WRIGHTS GLORIA G GUllN gyp pm 14 32 DATE OF DEATH 21 03-19-2013 U 141111 GO iJ(7 1 FILE NUMBER 21 13-0361 COUNTY CUMBERLAND CLERK OF SSN/DC RONALD R ELLIOTT ACN 13122861 1548 ORRSTOWN RD ORPHANS COURT APPEAL BY DATE:05-30-2014 SHIPPENSBURG PA 09REWMI) CO., PA (See reverse side under Objections) Amount Remitted (---- MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE --f' RETAIN LOWER PORTION FOR YOUR RECORDS 4— REV-1548 EX AFP C12-13) NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-31-2014 ESTATE OF:WRIGHTS GLORIA G DATE OF DEATH:03-19-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0361 S.S/D,C. NO. : ACN: 13122861 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PATRIOT FCU ACCOUNT NO. : 1096290-10 TYPE OF ACCOUNT: ( X)SAVINGS C ) CHECKING C )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 06-08-1996 Account Balance 1,824.06 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 912.03 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 912.03 REGISTER OF WILLS AT THE Tax Rate X .15 ABOVE ADDRESS. MAKE CHECK Tax Due 136.80 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID t-3 INTEREST IS CHARGED THROUGH 04-08-2014 TOTAL TAX PAYMENT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 136.80 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 1.23 TOTAL DUE 138.03 X IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. + IF TOTAL DUE IS REFLECTED AS A "CREDIT^ (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. \i�\ pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX/'�p��L�07y(��p�� � DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION Sy�AN6y.A6S MENTS OF TAX PO BOX 280601 REV-150 IX AFP (12-11) HARRISBURG PA 17128-0601 REGPS W EY VE1D,1(7tff ST ASSETS qq tttt'' 01pp VpIOT•� DATE 03-31-2014 '' 2017 i 171H 28 fl � 1� TOFODEATN 03-19-2013 FILE GLORIA G FILE NUMBER 21 13-0361 CLERK OF COUNTY CUMBERLAND ORPHANS COUR;SN/DC RONALD R ELLIOTT CUMBERLAN© Ca., A APPEAL BY DATE?052 1548 ORRSTOWN RD 30-2014 SHIPPENSBURG PA 17257-8821 (See reverse side under Objections) Amount Remittedf- MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4— ____________________________________________________________________ REY-1548 EX AFP C12-13> NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-31-2014 ESTATE OF:WRIGHTS GLORIA G DATE OF DEATH:03-19-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0361 S.S/D.C. NO. : ACN: 13122862 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PATRIOT FCU ACCOUNT NO. : 1096290-15 TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING ( )TRUST t )TIME CERTIFICATE DATE ESTABLISHED 12-24-1998 Account Balance 480.00 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 240.00 UPPER PORTION OF THIS NOTICE Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 240.00 REGISTER OF WILLS AT THE Tax Rate x • 15 ABOVE ADDRESS. MAKE CHECK Tax Due 36.00 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+3 AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) INTEREST IS CHARGED THROUGH 04-08-2014 TOTAL TAX PAYMENT .00 AT THE. RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 36.00 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .32 TOTAL DUE 36.32 > IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A ^CREDIT^ (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. pennsytvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE SAX DEPARTMENT OF REVENUE INHERITANCE TAX DIYISION APPRAISEMENt, ALLOWANCE OR DISALLOWANCE PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 IX AFP q2-i37 HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS DATE 03-03-2014 ESTATE OF WRIGHTS GLORIA G DATE OF DEATH 03-19-2013 FILE NUMBER 21 13-0361 COUNTY CUMBERLAND SSN/DC APRIL C WRIGHTS ACN 13117169 2 WILLOW DR APPEAL BY DATE:05-02-2014 SHIPPENSBURG PA 17257-9430 (See reverse side under Objections) Amount Remitted—` MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS I COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4— ___________________'-__----'_-__--______--_______--_____________-___ REV-1548 EX AFP C12-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-03-2014 ESTATE OF:WRIGHTS GLORIA G DATE OF DEATH:03-19-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0361 S.S/D.C. NO. : ACN: 13117169 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. : 420978-00 TYPE OF ACCOUNT: 00 SAVINGS C ) CHECKING ( )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 06-04-2011 Account Balance 1,350.50 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 675.25 UPPER PORTION OF THIS NOTICE Debts and Deductions - 100 WITH YOUR TAX PAYMENT TO THE Taxable Amount 675.25 REGISTER OF WILLS AT THE Tax Rate Y .045 ABOVE ADDRESS. MAKE-„CHECK Tax Due 30.39 OR MONEY 0 R PAYAFeE TO: _-� "REGISTER .I'. LLS, �GENic'C`: TAX CREDITS: x”' 'CD PAYMENT RECEIPT DISCOUNT DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID as INTEREST IS CHARGED THROUGH 03-11-2014 TOTAL TAX PAYMENT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 30.39 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .20 TOTAL DUE 30.59 + IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ` IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.